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Nonalcoholic fatty liver disease in obese adolescents: the role of genetic polymorphisms

Hepatobiliary Surgery and Nutrition 2019年第2期8卷 179-180页

作者： ludovico abenavoli Luigi Boccuto Department of Health Sciences University Magna GraeciaCatanzaroItaly Greenwood Genetic Center GreenwoodSCUSA Clemson University School of Health Research ClemsonSCUSA

Nonalcoholic fatty liver disease(NAFLD)has recently become an emerging health problem worldwide(1).The pathogenetic mechanisms involved in the development and progression of NAFLD are due to genetic predisposition that expresses a metabolic profile associated with high energy food intake(2).The most accurate estimate of the worldwide prevalence of NAFLD is 24–25%of the general population,and ranges from 5–18%in Asia to 20–30%in the Western countries(1,3).Nowadays,the reason for this variability is not clear yet.However,it is plausible that genetic factors could play a major role in pathogenesis and the advances in genomics,transcriptomics,and proteomics have highlighted new pathogenic pathways.In fact,increasing literature data support the role of single nucleotide polymorphisms(SNPs),and in particular the SNPs of genes involved in insulin signaling,lipid homeostasis,and oxidative stress,not only in the susceptibility to develop NAFLD,but also in the severity of liver damage and in the etiology of multisystemic metabolic disorders(4).The development of the Genome Wide Association Study technology has allowed the identification of many SNPs involved in the onset of NAFLD,since they can change the stages of development,the rate of progression,and the efficacy of treatment(5).Recently,Tricòet al.investigate the clinical and genetic features associated with pediatric NAFLD in a prospective study in a large multiethnic cohort of obese adolescents(6).A total of 503 subjects,identified as"The Yale Pediatric NAFLD cohort",were enrolled,including 191(38.0%)Caucasians,134(26.6%)African Americans,and 178(35.4%)Hispanics.

关键词： adolescent homeostasis intake

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Are probiotics effective in reversing non-alcoholic steatohepatitis?

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 407-409页

作者： ludovico abenavoli Luigi Boccuto Emidio Scarpellini Department of Health Sciences University Magna GraeciaCatanzaroItaly School of Nursing Clemson UniversityClemsonSCUSA Translational Research Center for Gastrointestinal Disorders Department of Chronic DiseasesMetabolism and AgeingCatholic University of LeuvenLeuvenBelgium

The gut microbiota(GM)is an integrated ecosystem of tens of trillions of microorganisms,as actinomyces,archaea,protozoa,and last but not least viruses,including one thousand different species of known bacteria with an overall count of more than three million genes,150 times more than the human genome.GM presents immune-modulating,absorptive and metabolic functions(1).

关键词： metabolic ecosystem

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Silymarin: An option to treat non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2017年第47期23卷 8437-8438页

作者： Carmela Colica Luigi Boccuto ludovico abenavoli CNR IBFM UOS of GermanetoUniversity“Magna Graecia” Research Department Greenwood Genetic CenterSchool of Health ResearchClemson University Department of Health Sciences University Magna GraeciaCampus GermanetoViale Europa

We have read with a great interest the review published by Singh et al, on the treatment options in alcoholic and non-alcoholic fatty liver disease, including various new targeted therapies that are currently under investigation. Recently, we described the health effects of the Mediterranean diet associated to an antioxidant complex rich in silymarin, to improve in overweight patients anthropometric parameters, glucose and lipid metabolism and intra-hepatic fat accumulation.

关键词：地中海饮食抗氧化剂 Silymarin 非酒精的脂肪肝疾病

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Probiotics supplementation in the management of hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2019年第6期8卷 632-634页

作者： ludovico abenavoli Francesco Luzza Nahum Mendez-Sanchez Department of Health Sciences University Magna GraeciaCatanzaroItaly Liver Research Unit Medica Sur Clinic&Foundation and Faculty of Medicine National Autonomous University of MexicoMexico CityMexico

Hepatocellular carcinoma(HCC,also known as primary liver cancer),is the fourth most frequent cancer and the third cause of deaths associated with cancer worldwide(1).HCC occurs in liver damaged tissue,due to chronic regenerative and inflammatory processes that contribute to the initiation and progression of the tumor(2).The main environmental factors associated with HCC are hepatotropic viral infection(hepatitis B and C,particularly),excessive consumption of alcohol,and exposure to aflatoxin through the diet.However,in the last 20 years,non-alcoholic fatty liver disease(NAFLD)has become a quickly emerging cause of end-stage liver disease worldwide.Typically,its hepatic injury starts with simple steatosis,which can progress to advanced stages such as non-alcoholic steatohepatitis(NASH),fibrosis and finally cirrhosis.Epidemiology studies report that about 3-15%of the obese patients with NASH progress to cirrhosis,and about 4-27%of NASH patients with cirrhosis present HCC(1).

关键词： hepatic NAFLD finally

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SARS-CoV-2 and liver damage:a possible pathogenetic link

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 322-324页

作者： ludovico abenavoli Ivan Gentile Alberto Enrico Maraolo Francesco Negro Department of Health Sciences University Magna GraeciaCatanzaroItaly Department of Clinical Medicine and Surgery Section of Infectious Diseases Member of UNESCO Chair on Health Education and Sustainable Development University of Naples"Federico II"NaplesItaly First Division of Infectious Diseases Cotugno HospitalAORN dei ColliNaplesItaly Divisions of Gastroenterology and Hepatology and of Clinical Pathology Geneva University HospitalsGenevaSwitzerland

On December 31,2019,the World Health Organization(WHO)China Country Office,was informed of pneumonia cases of unknown etiology detected in Wuhan,a city of Hubei Province in China.

关键词： China. Wuhan damage

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Adiponectin serum level in chronic hepatitis C infection and therapeutic profile

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World Journal of Hepatology 2015年第1期7卷 44-52页

作者： Valentina Peta Carlo Torti Natasa Milic Alfredo Foca ludovico abenavoli Department of Health Sciences University Magna GraciaCampus Germaneto88100 CatanzaroItaly Department of Medical and Surgical Sciences University Magna GraeciaCampus Germaneto88100 CatanzaroItaly Department of Pharmacy University of Novi Sad21000 Novi SadSerbia

Hepatic steatosis is commonly seen in the patients with chronic hepatitis C virus(HCV) infection. HCV is closely associated with lipid metabolism,and viral steatosis is more common in genotype 3 infection owing to a direct cytopathic effect of HCV core protein. In non-genotype3 infection,hepatic steatosis is considered largely to be the result of the alterations in host metabolism; metabolic steatosis is primarily linked with HCV genotype 1. A d i p o s e t i s s u e s e c r e t e s d i f f e r e n t h o r m o n e s involved in glucose and lipid metabolisms. It has been demonstrated that adipocytokines are involved in the pathogenesis of non-alcoholic fatty liver disease,as the decreased plasma adiponectin levels,a soluble matrix protein expressed by adipoctyes and hepatocyte,are associated with liver steatosis. Various studies have shown that steatosis is strongly correlated negatively with adiponectin in the patients with HCV infection. The role of adiponectin in hepatitis C virus induced steatosis is still not completely understood,but the relationship between adiponectin low levels and liver steatosis is probably due to the ability of adiponectin to protect hepatocytes from triglyceride accumulation by increasing β-oxidation of free fatty acid and thus decreasing de novo free fatty acid production.

关键词： Hepatitis C virus Adiponectin Metabolism Insulin resistance Hepatitis C virus core protein

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Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2017年第17期23卷 3150-3162页

作者： Chiara Gelli Mirko Tarocchi ludovico abenavoli Laura Di Renzo Andrea Galli Antonino De Lorenzo Division of Clinical Nutrition and Nutrigenomics Department of Biomedicine and PreventionUniversity of Rome“Tor Vergata” Department of Experimental and Clinical Biomedical Sciences University of Florence Department of Health Sciences University Magna Graecia

AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

关键词：非酒精的脂肪肝疾病非酒精的 steatohepatitis 地中海饮食新陈代谢的症候群治疗学的途径建议饮食生活方式

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No evidence of circulating autoantibodies against osteoprotegerin in patients with celiac disease

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World Journal of Gastroenterology 2012年第14期18卷 1622-1627页

作者： Tiziana Larussa Evelina Suraci Immacolata Nazionale Isabella Leone Tiziana Montalcini ludovico abenavoli Maria Imeneo Arturo Pujia Francesco Luzza Department of Health Science University of Catanzaro "Magna Graecia"88100 CatanzaroItaly Department of Medical and Surgical Science University of Catanzaro "Magna Graecia"88100 CatanzaroItaly

AIM:To investigate risk factors for low bone mineral density(BMD) in celiac disease(CD) patients,focusing on circulating autoantibodies against osteoprotegerin(OPG).METHODS:Seventy asymptomatic CD adult patients on gluten-free diet(GFD) and harbouring persistent negative CD-related serology were recruited.Conventional risk factors for osteoporosis(e.g.,age,sex,menopausal status,history of fractures,smoke,and body mass index) were checked and BMD was assessed by dual energy X ray absorptiometry.Serum calcium and parathyroid hormone(PTH) levels were evaluated.Thirty-eight patients underwent repeat duodenal biopsy.Serum samples from a selected sub-group of 30 patients,who were also typed for human leukocyte antigen(HLA) DQ2 and DQ8 haplotype,were incubatedwith homodimeric recombinant human OPG and tested by western blotting with an anti-OPG antibody after immunoprecipitation.RESULTS:Despite persistent negative CD-related serology and strict adherence to GFD,49 out of the 70(74%) patients displayed low BMD.Among these patients,13(24%) showed osteoporosis and 36(76%) osteopenia.With the exception of age,conventional risk factors for osteoporosis did not differ between patients with normal and low BMD.Circulating serum calcium and PTH levels were normal in all patients.Duodenal mucosa healing was found in 31(82%) out of 38 patients who underwent repeat duodenal biopsy with 20(64%) still displaying low BMD.The remaining 7 patients had an incomplete normalization of duodenal mucosa with 6(84%) showing low BMD.No evidence of circulating antibodies against OPG was found in the serum of 30 celiac patients who were tested for,independent of BMD,duodenal histology,and HLA status.CONCLUSION:If any,the role of circulating autoantibodies against OPG in the pathogenesis of bone derangement in patients with CD is not a major one.

关键词：循环抗体证据患者疾病腹腔风险因素骨矿化

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Pharmacotherapy of acute alcoholic hepatitis in clinical practice

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World Journal of Gastroenterology 2014年第9期20卷 2159-2167页

作者： ludovico abenavoli Natasa Milic Samir Rouabhia Giovanni Addolorato Department of Health Sciences University Magna Graecia Campus Germaneto 88100 CatanzaroItaly Department of Pharmacy University of Novi Sad 21000 Novi Sad Serbia Department of Internal Medicine University Hospital Center Touhami Benfis Batna 05000 Algeria Department of Internal Medicine Catholic University of Rome 00168 Rome Italy

Severe alcoholic hepatitis(AH)is an acute form of alcohol induced liver disease with a poor prognosis that is seen in the patients who consume large quantities of alcohol.The diagnosis of AH is based on the appropriate alcohol intake history and is supported with clinical and histological features,and several scoring systems.Glucocorticoids are the mainstay for treating severe AH with pentoxifylline used as an alternative to steroids in addition to total alcohol abstinence.Liver transplantation is a possible therapeutic option for severe AH.Among the anti-craving medications able to improve abstinence rate,baclofen seems to be effective and safe in the alcoholic patients affected by severe liver damage.

关键词： Severe alcoholic hepatitis Maddrey’s discriminant

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Role of endoscopy in management of gastrointestinal complications of portal hypertension

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World Journal of Gastrointestinal Endoscopy 2015年第1期7卷 1-12页

作者： Carmelo Luigiano Giuseppe Iabichino Antongiulio Judica Clara Virgilio Valentina Peta ludovico abenavoli Unit of Gastroenterology and Digestive Endoscopy ARNAS Garibaldi95122 CataniaItaly Postgraduate School of Gastroenterology University of Catania95122 CataniaItaly Department of Health Science University Magna Gracia88100 CatanzaroItaly

The management of patients with gastrointestinal complications of portal hypertension is often complex and challenging. The endoscopy plays an important role in the management of these patients. The role of endoscopy is both diagnostic and interventional and in the last years the techniques have undergone a rapid expansion with the advent of different and novel endoscopic modalities, with consequent improvement of investigation and treatment of these patients. The choice of best therapeutic strategy depends on many factors: baseline disease, patient's clinical performance and the timing when it is done if in emergency or a prophylactic approaches. In this review we evaluate the endoscopic management of patients with the gastrointestinal complications of portal hypertension.

关键词： Portal hypertension Gastrointestinal complications Bleeding Esophageal varices Gastric varices

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